Big Bubble DALK
Contributed by Matt Ward, MD and Mark Greiner, MD
If video fails to load, use this link
Deep Anterior Lamellar Keratoplasty (DALK) Some diseases affect just the front part of the cornea, leaving the back part intact. Severe keratoconus and corneal scarring are the most common reasons to transplant just the front part of the cornea. Deep Anterior Lamellar Keratoplasty (DALK) is the technique Dr. Ward uses to separate and remove the front part of the cornea that has been damaged by keratoconus or scarring while leaving the patient's own deep corneal layer called "endothelium" intact. The endothelium is critically important as it pumps the rest of the cornea free of fluid and keeps it clear. With DALK, the patient can keep their own endothelium, which functions perfectly well, while receiving new tissue at the front to strengthen the cornea and restore clarity. DALK eliminates the possibility of endothelial rejection, which comprises the majority of corneal rejection episodes.
